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Ruiz Del Pino M, Rosales-Castillo A, Navarro-Marí JM, Gutiérrez-Fernández J. Clinical significance of isolation of Haemophilus no ducreyi in genital samples. Systematic review. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:468-484. [PMID: 36443187 DOI: 10.1016/j.eimce.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES Currently, the microbiological diagnosis of genital infections is carried out with molecular methods, which allow the detection of less frequent etiological agents but with potential pathogenic importance, such as Haemophilus spp. The objective of this review is to analyse and highlight the clinical importance of the isolation of Haemophilus spp. in genital and rectal infections, excluding Haemophilus ducreyi. MATERIAL AND METHODS A systematic review was carried out based on an exhaustive search of the publications included in the MEDLINE database up to August 5, 2021, on the presence of Haemophilus spp. in genital and rectal infections, excluding H. ducreyi. RESULTS After reviewing what was described in the literature, Haemophilus spp. (excluding H. ducreyi: HSNOD) was detected in 2397 episodes of genital infection, the most frequently isolated species being H. influenzae and H. parainfluenzae. Most of the episodes (87,6%) are constituted by single isolation. There is a slight predominance in women (48,3%) where it can cause vaginitis, salpingitis, endometritis or complications during pregnancy. In men, the clinical picture usually corresponds to urethritis. Most of the samples correspond to vaginal and urethral exudates, with a minority representation at the rectal level (2.3%). CONCLUSION HSNOD plays a relevant pathogenic role in episodes of genital infection, so microbiological diagnostic protocols must include methods that allow their detection, as well as include them in the etiological spectrum of this type of clinical picture.
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Affiliation(s)
- Marta Ruiz Del Pino
- Departamento de Microbiología, Facultad de Medicina, Universidad de Granada-ibs, Granada, Spain
| | - Antonio Rosales-Castillo
- Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves-ibs, Granada, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain.
| | - José María Navarro-Marí
- Departamento de Microbiología, Hospital Universitario Virgen de las Nieves-ibs, Granada, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain
| | - José Gutiérrez-Fernández
- Departamento de Microbiología, Facultad de Medicina, Universidad de Granada-ibs, Granada, Spain; Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain
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2
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Toh E, Xing Y, Gao X, Jordan SJ, Batteiger TA, Batteiger BE, Van Der Pol B, Muzny CA, Gebregziabher N, Williams JA, Fortenberry LJ, Fortenberry JD, Dong Q, Nelson DE. Sexual behavior shapes male genitourinary microbiome composition. Cell Rep Med 2023; 4:100981. [PMID: 36948151 PMCID: PMC10040456 DOI: 10.1016/j.xcrm.2023.100981] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/21/2022] [Accepted: 02/23/2023] [Indexed: 03/24/2023]
Abstract
The origin, composition, and significance of the distal male urethral microbiome are unclear, but vaginal microbiome dysbiosis is linked to new sex partners and several urogynecological syndromes. We characterized 110 urethral specimens from men without urethral symptoms, infections, or inflammation using shotgun metagenomics. Most urethral specimens contain characteristic lactic acid bacteria and Corynebacterium spp. In contrast, several bacteria associated with vaginal dysbiosis were present only in specimens from men who reported vaginal intercourse. Sexual behavior, but not other evaluated behavioral, demographic, or clinical variables, strongly associated with inter-specimen variance in urethral microbiome composition. Thus, the male urethra supports a simple core microbiome that is established independent of sexual exposures but can be re-shaped by vaginal sex. Overall, the results suggest that urogenital microbiology and sexual behavior are inexorably intertwined, and show that the male urethra harbors female urogenital pathobionts.
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Affiliation(s)
- Evelyn Toh
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yue Xing
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Xiang Gao
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Stephen J Jordan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Teresa A Batteiger
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Byron E Batteiger
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Barbara Van Der Pol
- Department of Medicine, Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christina A Muzny
- Department of Medicine, Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Netsanet Gebregziabher
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James A Williams
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lora J Fortenberry
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J Dennis Fortenberry
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Qunfeng Dong
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA; Center for Biomedical Informatics, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
| | - David E Nelson
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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3
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Ruiz del Pino M, Rosales-Castillo A, Navarro-Marí JM, Gutiérrez-Fernández J. Importancia clínica del aislamiento de Haemophilus spp. (excluyendo H. ducreyi) en muestras genitales. Revisión sistemática. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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4
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Nayyar R, Dadhwal R, Kapil A, Pandey RM, Dogra P. Urethral Instillation of Povidone-Iodine Reduces Post-Cystoscopy Urinary Tract Infection in Males: A Randomized Controlled Trial. Sci Rep 2020; 10:3585. [PMID: 32108161 PMCID: PMC7046644 DOI: 10.1038/s41598-020-60522-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/13/2020] [Indexed: 11/09/2022] Open
Abstract
Office cystoscopy may be associated with urinary tract infection (UTI) in up to 10-20% of patients. Current practice of surgical part preparation in males with povidone-iodine excludes distal urethra in males, leaving a possibility for resident intra-urethral flora to cause post-procedural UTI. We designed this randomized study to assess whether additional cleaning of distal urethra with povidone-iodine solution can help reduce post-procedural incidence of UTIs in this setting. Additionally, urethral swab culture was done in the entire cohort to identify the prevalent microflora in the distal male urethra and to evaluate its role in causation of post-procedural UTI. Using a specialized urethral swab culture methodology, 85% males demonstrated some bacteria and 16% showed common uro-pathogens. 28 (14.5%) cases had post-procedure culture positive UTI. The incidence of UTI in control group (22%) was significantly more than the intervention group (7%) (p value <0.007). This result strongly supports inclusion of distal urethral irrigation with povidone-iodine in males before office cystoscopy, even when pre-procedure mid-stream urine culture is sterile.
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Affiliation(s)
- Rishi Nayyar
- Department of Urology, AIIMS, New Delhi, 110029, New Delhi, India.
| | - Rohit Dadhwal
- Department of Urology, AIIMS, New Delhi, 110029, New Delhi, India
| | - Arti Kapil
- Department of Microbiology, AIIMS, New Delhi, 110029, New Delhi, India
| | | | - PremNath Dogra
- Department of Urology, AIIMS, New Delhi, 110029, New Delhi, India
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5
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Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? - a position statement from the European STI Guidelines Editorial Board. J Eur Acad Dermatol Venereol 2018; 32:1845-1851. [PMID: 29924422 DOI: 10.1111/jdv.15146] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/12/2018] [Indexed: 12/12/2022]
Abstract
At present, we have no evidence that we are doing more good than harm detecting and subsequently treating Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum colonizations/infections. Consequently, routine testing and treatment of asymptomatic or symptomatic men and women for M. hominis, U. urealyticum and U. parvum are not recommended. Asymptomatic carriage of these bacteria is common, and the majority of individuals do not develop any disease. Although U. urealyticum has been associated with urethritis in men, it is probably not causal unless a high load is present (likely carriage in 40-80% of detected cases). The extensive testing, detection and subsequent antimicrobial treatment of these bacteria performed in some settings may result in the selection of antimicrobial resistance, in these bacteria, 'true' STI agents, as well as in the general microbiota, and substantial economic cost for society and individuals, particularly women. The commercialization of many particularly multiplex PCR assays detecting traditional non-viral STIs together with M. hominis, U. parvum and/or U. urealyticum has worsened this situation. Thus, routine screening of asymptomatic men and women or routine testing of symptomatic individuals for M. hominis, U. urealyticum and U. parvum is not recommended. If testing of men with symptomatic urethritis is undertaken, traditional STI urethritis agents such as Neisseria gonorrhoeae, Chlamydia trachomatis, M. genitalium and, in settings where relevant, Trichomonas vaginalis should be excluded prior to U. urealyticum testing and quantitative species-specific molecular diagnostic tests should be used. Only men with high U. urealyticum load should be considered for treatment; however, appropriate evidence for effective treatment regimens is lacking. In symptomatic women, bacterial vaginosis (BV) should always be tested for and treated if detected.
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Affiliation(s)
- P Horner
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol, UK
| | - G Donders
- Department of Obstetrics and Gynecology, University Hospital Antwerp, Edegem, Belgium
| | - M Cusini
- Department of Dermatology, Fondazione IRCCS Ca' Granda Ospedale Policlinico, Milano, Italy
| | - M Gomberg
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - J S Jensen
- Infection Preparedness, Research Unit for Reproductive Tract Microbiology, Statens Serum Institut, Copenhagen, Denmark
| | - M Unemo
- Department of Laboratory Medicine, Microbiology, World Health Organization Collaborating Centre for Gonorrhoea and Other STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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6
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Commensal bacterial modulation of the host immune response to ameliorate pain in a murine model of chronic prostatitis. Pain 2018; 158:1517-1527. [PMID: 28715352 DOI: 10.1097/j.pain.0000000000000944] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The human commensal microflora plays an essential role in modulating the immune response to control homeostasis. Staphylococcus epidermidis, a commensal bacterium most commonly associated with the skin exerts such effects locally, modulating local immune responses during inflammation and preventing superinfection by pathogens such as Staphylococcus aureus. Although the prostate is considered by many to be sterile, multiple investigations have shown that small numbers of gram-positive bacterial species such as S. epidermidis can be isolated from the expressed prostatic secretions of both healthy and diseased men. Chronic pelvic pain syndrome is a complex syndrome with symptoms including pain and lower urinary tract dysfunction. It has an unknown etiology and limited effective treatments but is associated with modulation of prostate immune responses. Chronic pelvic pain syndrome can be modeled using murine experimental prostatitis (EAP), where CD4+ve IL17A+ve T cells have been shown to play a critical role in disease orchestration and development of pelvic tactile allodynia. Here, we report that intraurethral instillation of a specific S. epidermidis strain (designated NPI [non-pain inducing]), isolated from the expressed prostatic secretion of a healthy human male, into EAP-treated mice reduced the pelvic tactile allodynia responses and increased CD4+ve IL17A+ve T-cell numbers associated with EAP. Furthermore, a cell wall constituent of NPI, lipoteichoic acid, specifically recapitulates these effects and mediates increased expression of CTLA4-like ligands PDL1 and PDL2 on prostatic CD11b+ve antigen-presenting cells. These results identify a new potential therapeutic role for commensal S. epidermidis NPI lipoteichoic acid in the treatment of prostatitis-associated pain.
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7
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The first report: An analysis of bacterial flora of the first voided urine specimens of patients with male urethritis using the 16S ribosomal RNA gene-based clone library method. Microb Pathog 2016; 95:95-100. [DOI: 10.1016/j.micpath.2016.02.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 11/22/2022]
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8
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Yokoyama H, Domen T, Hiragata S, Ogawa T, Matsumoto T, Ishizuka O. Postoperative Mycoplasma hominis infection after robot-assisted laparoscopic radical prostatectomy: A case report. Asian J Endosc Surg 2016; 9:146-8. [PMID: 27117965 DOI: 10.1111/ases.12258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/09/2015] [Accepted: 10/19/2015] [Indexed: 11/30/2022]
Abstract
A 59-year-old man developed a high fever, elevated white blood cell count, elevated C-reactive protein level, and perineal pain 5 days after robot-assisted laparoscopic radical prostatectomy. Treatment with cefmetazole was ineffective. A urine specimen was submitted for culture on postoperative day 7, and Mycoplasma hominis (M. hominis) was detected 1 week later. Cefmetazole was therefore switched to quinolone. The clinical symptoms and laboratory data immediately showed marked improvement. M. hominis has been shown to inhabit the genitourinary tract. Although it is considered to induce urethritis, its pathogenicity in healthy male subjects has not been investigated. M. hominis is difficult to detect and is resistant to β-lactams because it lacks a cell wall. Urine culture sometimes results in false-negative results. In cases where empirical therapy for postoperative infection is ineffective, surgeons should recognize the possibility of M. hominis involvement and consider changing the antibiotic used.
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Affiliation(s)
- Hitoshi Yokoyama
- Department of Urology, School of Medicine Shinshu University, Matsumoto, Japan
| | - Takahisa Domen
- Department of Urology, School of Medicine Shinshu University, Matsumoto, Japan
| | - Shiro Hiragata
- Department of Urology, School of Medicine Shinshu University, Matsumoto, Japan
| | - Teruyuki Ogawa
- Department of Urology, School of Medicine Shinshu University, Matsumoto, Japan
| | - Takehisa Matsumoto
- Laboratory Medicine, School of Medicine Shinshu University, Matsumoto, Japan
| | - Osamu Ishizuka
- Department of Urology, School of Medicine Shinshu University, Matsumoto, Japan
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9
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Reid G, Kumar H, Khan AI, Rautava S, Tobin J, Salminen S. The case in favour of probiotics before, during and after pregnancy: insights from the first 1,500 days. Benef Microbes 2016; 7:353-62. [PMID: 26839074 DOI: 10.3920/bm2015.0140] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Successful human reproduction requires microbial homeostasis in the female reproductive tract, and colonisation of the newborn with beneficial microbes. In order to prevent several complications associated with dysbiosis, the administration of probiotics is more often being considered. The objective of the enclosed review was to examine the rationale for probiotic utility before and during pregnancy and in the early phase of infant life. The conclusions emerged from a panel of researchers who met during the International Scientific Association for Probiotics and Prebiotics (ISAPP) workshop held in Washington, DC, USA in 2015. The group concluded based upon the current literature, that a case can be made for the use of a specific sets of probiotic organisms during the first 1,500 days of life, with the goal of a healthy pregnancy to term, and a healthy start to life with lowered risk of infections and inflammatory events. The key to successfully translating these recommendations to practice is that products be made available and affordable to women in developed and developing countries.
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Affiliation(s)
- G Reid
- 1 Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada.,2 Department of Microbiology and Immunology, University of Western Ontario, London, Ontario N6A 5C1, Canada
| | - H Kumar
- 3 Functional Foods Forum, University of Turku, Itäinenpitkäkatu 4 A, 20014 Turku, Finland
| | - A I Khan
- 4 Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, P.O. Box 128, Dhaka 1000, Bangladesh
| | - S Rautava
- 5 Department of Pediatrics, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - J Tobin
- 6 Melbourne Medical School Centre for Indigenous Health Equity, 207 Bouverie St, Parkville, Melbourne 3010, Victoria, Australia
| | - S Salminen
- 3 Functional Foods Forum, University of Turku, Itäinenpitkäkatu 4 A, 20014 Turku, Finland
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10
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Martin DH, Ferris MJ. Endogenous Microbiota of the Genitourinary Tract. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00007-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Abstract
We describe herein a case of uropathogenic Escherichia coli urethritis and orchiepididymitis in a heterosexual man, which he had acquired sexually from his girlfriend. The identity of the genital isolates from both partners was confirmed by pulsed-field gel electrophoresis.
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12
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Mändar R. Microbiota of male genital tract: Impact on the health of man and his partner. Pharmacol Res 2013; 69:32-41. [DOI: 10.1016/j.phrs.2012.10.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 10/16/2012] [Accepted: 10/29/2012] [Indexed: 10/27/2022]
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13
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Nelson DE, Dong Q, Van Der Pol B, Toh E, Fan B, Katz BP, Mi D, Rong R, Weinstock GM, Sodergren E, Fortenberry JD. Bacterial communities of the coronal sulcus and distal urethra of adolescent males. PLoS One 2012; 7:e36298. [PMID: 22606251 PMCID: PMC3350528 DOI: 10.1371/journal.pone.0036298] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 03/30/2012] [Indexed: 12/20/2022] Open
Abstract
Lactobacillus-dominated vaginal microbiotas are associated with reproductive health and STI resistance in women, whereas altered microbiotas are associated with bacterial vaginosis (BV), STI risk and poor reproductive outcomes. Putative vaginal taxa have been observed in male first-catch urine, urethral swab and coronal sulcus (CS) specimens but the significance of these observations is unclear. We used 16 S rRNA sequencing to characterize the microbiota of the CS and urine collected from 18 adolescent men over three consecutive months. CS microbiotas of most participants were more stable than their urine microbiotas and the composition of CS microbiotas were strongly influenced by circumcision. BV-associated taxa, including Atopobium, Megasphaera, Mobiluncus, Prevotella and Gemella, were detected in CS specimens from sexually experienced and inexperienced participants. In contrast, urine primarily contained taxa that were not abundant in CS specimens. Lactobacilllus and Streptococcus were major urine taxa but their abundance was inversely correlated. In contrast, Sneathia, Mycoplasma and Ureaplasma were only found in urine from sexually active participants. Thus, the CS and urine support stable and distinct bacterial communities. Finally, our results suggest that the penis and the urethra can be colonized by a variety of BV-associated taxa and that some of these colonizations result from partnered sexual activity.
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Affiliation(s)
- David E. Nelson
- Department of Biology, Indiana University, Bloomington, Indiana, United States of America
| | - Qunfeng Dong
- Department of Biological Sciences, Department of Computer Science & Engineering, University of North Texas, Denton, Texas, United States of America
| | - Barbara Van Der Pol
- School of Public Health, Indiana University, Bloomington, Indiana, United States of America
| | - Evelyn Toh
- Department of Biology, Indiana University, Bloomington, Indiana, United States of America
| | - Baochang Fan
- Department of Biology, Indiana University, Bloomington, Indiana, United States of America
| | - Barry P. Katz
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Deming Mi
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Ruichen Rong
- Department of Biological Sciences, Department of Computer Science & Engineering, University of North Texas, Denton, Texas, United States of America
| | - George M. Weinstock
- Department of Genetics, Washington University St. Louis School of Medicine, St. Louis, Missouri, United States of America
| | - Erica Sodergren
- Department of Genetics, Washington University St. Louis School of Medicine, St. Louis, Missouri, United States of America
| | - J. Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
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14
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Wetmore CM, Manhart LE, Lowens MS, Golden MR, Jensen NL, Astete SG, Whittington WLH, Totten PA. Ureaplasma urealyticum is associated with nongonococcal urethritis among men with fewer lifetime sexual partners: a case-control study. J Infect Dis 2011; 204:1274-82. [PMID: 21917901 DOI: 10.1093/infdis/jir517] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ureaplasmas have been inconsistently associated with nongonococcal urethritis (NGU). We evaluated the association of the newly differentiated species Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) with NGU using 2 separate control groups. METHODS Case patients were men who attended a sexually transmitted disease (STD) clinic in Seattle, Washington, during the period 2007-2009 with NGU (defined as visible urethral discharge and/or ≥5 polymorphonuclear neutrophils per high-powered field; n = 329). Control subjects were STD clinic attendees (n = 191) and emergency department (ED) attendees (n = 193) without NGU. Polymerase chain reaction assays detected UU and UP in ureaplasma culture-positive urine. Multivariable logistic regression was used to assess the associations of UU and UP with NGU. RESULTS UU was only marginally associated with NGU in aggregate multivariable analyses, irrespective of control group (adjusted odds ratio [aOR](STD-control), 1.6 [95% confidence interval {CI}, 0.9-2.8]; aOR(ED-control), 1.7 [95% CI, 0.97-3.0]). This association was significantly stronger when analyses were restricted to men with fewer lifetime sex partners (<10 vaginal partners: aOR(STD-control), 2.9 [95% CI, 1.2-6.7]; aOR(ED-control), 3.2 [95% CI, 1.3-7.6]; <5 vaginal partners: aOR(STD-control), 6.2 [95% CI, 1.8-21.0]; aOR(ED-control), 5.2 [95% CI, 1.3-20.2]). UP was not positively associated with NGU overall or among subgroups. CONCLUSIONS The absence of an association of UU with NGU among men with more lifetime sex partners suggests that adaptive immunity may attenuate the clinical manifestation of UU infection. Similar relationships were not observed with UP, which suggests that it is not a urethral pathogen.
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Affiliation(s)
- Catherine M Wetmore
- Center for AIDS and STD, University of Washington, Seattle, Washington, USA.
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15
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Ito S, Tsuchiya T, Yasuda M, Yokoi S, Nakano M, Deguchi T. Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years-of-age with acute epididymitis. Int J Urol 2011; 19:234-8. [DOI: 10.1111/j.1442-2042.2011.02917.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Dong Q, Nelson DE, Toh E, Diao L, Gao X, Fortenberry JD, Van Der Pol B. The microbial communities in male first catch urine are highly similar to those in paired urethral swab specimens. PLoS One 2011; 6:e19709. [PMID: 21603636 PMCID: PMC3094389 DOI: 10.1371/journal.pone.0019709] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 04/11/2011] [Indexed: 02/07/2023] Open
Abstract
Urine is the CDC-recommended specimen for STI testing. It was unknown if the
bacterial communities (microbiomes) in urine reflected those in the distal male
urethra. We compared microbiomes of 32 paired urine and urethral swab specimens
obtained from adult men attending an STD clinic, by 16S rRNA PCR and deep
pyrosequencing. Microbiomes of urine and swabs were remarkably similar,
regardless of STI status of the subjects. Thus, urine can be used to
characterize urethral microbiomes when swabs are undesirable, such as in
population-based studies of the urethral microbiome or where multiple sampling
of participants is required.
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Affiliation(s)
- Qunfeng Dong
- Department of Biology, University of North
Texas, Denton, Texas, United States of America
- Department of Computer Science and
Engineering, University of North Texas, Denton, Texas, United States of
America
| | - David E. Nelson
- Department of Biology, Indiana University,
Bloomington, Indiana, United States of America
- * E-mail: (BVDP); (DEN)
| | - Evelyn Toh
- Department of Biology, Indiana University,
Bloomington, Indiana, United States of America
| | - Lixia Diao
- Department of Bioinformatics and Computational
Biology, M.D. Anderson Cancer Center, University of Texas, Houston, Texas,
United States of America
| | - Xiang Gao
- Department of Biology, University of North
Texas, Denton, Texas, United States of America
| | - J. Dennis Fortenberry
- Section of Adolescent Medicine, Department of
Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United
States of America
| | - Barbara Van Der Pol
- Indiana University School of Public Health,
Bloomington, Indiana, United States of America
- Indiana University School of Medicine,
Indianapolis, Indiana, United States of America
- * E-mail: (BVDP); (DEN)
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Nelson DE, Van Der Pol B, Dong Q, Revanna KV, Fan B, Easwaran S, Sodergren E, Weinstock GM, Diao L, Fortenberry JD. Characteristic male urine microbiomes associate with asymptomatic sexually transmitted infection. PLoS One 2010; 5:e14116. [PMID: 21124791 PMCID: PMC2991352 DOI: 10.1371/journal.pone.0014116] [Citation(s) in RCA: 179] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 11/02/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The microbiome of the male urogenital tract is poorly described but it has been suggested that bacterial colonization of the male urethra might impact risk of sexually transmitted infection (STI). Previous cultivation-dependent studies showed that a variety of non-pathogenic bacteria colonize the urethra but did not thoroughly characterize these microbiomes or establish links between the compositions of urethral microbiomes and STI. METHODOLOGY/FINDINGS Here, we used 16S rRNA PCR and sequencing to identify bacteria in urine specimens collected from men who lacked symptoms of urethral inflammation but who differed in status for STI. All of the urine samples contained multiple bacterial genera and many contained taxa that colonize the human vagina. Uncultivated bacteria associated with female genital tract pathology were abundant in specimens from men who had STI. CONCLUSIONS Urine microbiomes from men with STI were dominated by fastidious, anaerobic and uncultivated bacteria. The same taxa were rare in STI negative individuals. Our findings suggest that the composition of male urine microbiomes is related to STI.
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Affiliation(s)
- David E Nelson
- Department of Biology, Indiana University, Bloomington, Indiana, USA.
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18
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Wetmore CM, Manhart LE, Golden MR. Idiopathic urethritis in young men in the United States: prevalence and comparison to infections with known sexually transmitted pathogens. J Adolesc Health 2009; 45:463-72. [PMID: 19837352 PMCID: PMC2764555 DOI: 10.1016/j.jadohealth.2009.06.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Revised: 06/18/2009] [Accepted: 06/30/2009] [Indexed: 01/07/2023]
Abstract
PURPOSE Urethritis is the most common male reproductive tract disease syndrome; yet 20-50% of diagnosed cases have no defined etiology, and few population-level data exist on the prevalence or etiology of the syndrome. We estimated the prevalence of urethritis among young men in the United States and compared correlates of idiopathic cases to correlates of detected infections with sexually transmitted pathogens. METHODS Questionnaire data and urine specimens from 5,447 men aged 18-27 years participating in Wave III of the National Longitudinal Study of Adolescent Health were analyzed. Symptomatic urethritis was defined as self-reported dysuria or urethral discharge in the past 24hours. Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium were identified using nucleic acid amplification tests. Idiopathic urethritis (IU) was defined as urethral symptoms in the absence of these four pathogens. Stratified weighted analyses generated population-based estimates. RESULTS Urethritis was reported by 1.2% (95% CI=.8-1.6%) of men, of whom 82.4% (61.1-93.3%) had IU. Men with previous STD diagnoses (aOR=9.3 [95% CI=3.0-28.7]), or fewer (1-4) or no lifetime vaginal sex partners (aOR=7.5 [2.9-19.3] and aOR=7.2 [1.9-27.4]), were more likely to have IU compared with men without urethral symptoms or identified pathogens, whereas men of Native American or Asian/Pacific Islander descent (aOR=.04 [.01-.2]) and heavy drinkers (aOR=.08 [.03-.2]) were less likely to have IU. Unlike infection with known pathogens, IU was not associated with black race, Hispanic ethnicity, or age at sexual debut. CONCLUSIONS Urethral symptoms were rarely associated with known pathogens. IU and known pathogens were associated with distinct characteristics.
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Affiliation(s)
- Catherine M. Wetmore
- Department of Epidemiology, University of Washington, Seattle, WA
- Department of Center for AIDS and STD, University of Washington, Seattle, WA
| | - Lisa E. Manhart
- Department of Epidemiology, University of Washington, Seattle, WA
- Department of Center for AIDS and STD, University of Washington, Seattle, WA
| | - Matthew R. Golden
- Department of Medicine, University of Washington, Seattle, WA
- Department of Center for AIDS and STD, University of Washington, Seattle, WA
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Biros E, Bodnár J, Biros I, Birosová E, Mojzis J, Hrivnák M, Klimcáková L, Findlay I, Mirossay A, Mirossay L. Molecular detection of Ureaplasma urealyticum infection from clinical urogenital swabs. Folia Microbiol (Praha) 2008; 52:443-6. [PMID: 18062195 DOI: 10.1007/bf02932101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A simple nucleic acid amplification test (NAAT) was developed for detection of Ureaplasma urealyticum infection based on the PCR amplification of the urease gene (UU1/UU2 Test). DNA was extracted from urogenital swabs and a 225-bp long DNA fragment was amplified by PCR. NAAT was compared to the commercial amplification kit for sexually transmitted disease reference assay. The sensitivity and specificity of the UU1/UU2 Test were determined to be 100 and 98.9%, respectively. The overall prevalence rate in this group of patients was found to be about 236 per 1000 (283 and 166 per 1000 in females and males, respectively). These data demonstrate that UU1/UU2 Test is suitable for effective epidemiological screening and/or diagnostic practice.
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Affiliation(s)
- E Biros
- Department of Pharmacology, Faculty of Medicine, P.J. Safárik University, 040 66 Kosice, Slovakia
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20
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Shannon BA, Cohen RJ, Garrett KL. Polymerase chain reaction-based identification of Propionibacterium acnes types isolated from the male urinary tract: evaluation of adolescents, normal adults and men with prostatic pathology. BJU Int 2006; 98:388-92. [PMID: 16879683 DOI: 10.1111/j.1464-410x.2006.06273.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess whether colonization of the male urinary tract with Propionibacterium acnes, in particular types IB and II (which are associated with inflammation in radical prostatectomy specimens and might be involved in the development of prostate cancer), is associated with prostate disease, and thus to develop a urine test to detect men at risk of prostate disease. PATIENTS, SUBJECTS AND METHODS We developed the first polymerase chain reaction (PCR)-based technique for identifying P. acnes types IA, IB and II, and used this in combination with selective culture medium to compare the prevalence of these subtypes in the urinary tract of adolescent males, healthy adult men and patients with confirmed prostate pathology. RESULTS P. acnes types IB and II were no more prevalent in the urinary tract of patients with prostate pathology than in normal control men. However, the prevalence of types IB and II appeared to be higher in adult men (at 11 of 15 and six of 15, respectively) than in adolescents (two of six and one of six), suggesting an age-related increase. Comparison of urinary tract and facial skin P. acnes from three subjects showed that type IA was more often predominant on facial skin, whereas types IB or II were more often predominant in the urinary tract. CONCLUSIONS A urine test might not be useful for detecting men with prostatic P. acnes infection and thus at greater risk of associated prostate disease. However, this work validated our technique for detecting and identifying the three P. acnes subtypes, and identified some interesting trends worth further investigation.
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21
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Abstract
Incidental foci of prostate cancer are found at autopsy in 30% of men in their third decade, and by their eighth decade more than 75% have histological evidence of cancer. This unprecedented cancer prevalence points to a ubiquitous causative agent or perhaps an interaction between multiple common carcinogenic cofactors. We propose that one of these carcinogens is Propionibacterium acnes. Several characteristics of prostate cancer suggest the involvement of an infectious agent and we provide evidence that P. acnes is an excellent candidate. We have cultured P. acnes from a substantial proportion of prostate glands containing cancer and shown a significant positive association with prostatic inflammation. P. acnes is well suited to cause persistent, low-grade infection involving a marked inflammatory response and the P. acnes subtypes most frequently associated with prostate cancer become highly prevalent in the urinary tract of males following puberty.
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Abstract
Nongonococcal urethritis (NGU) is a common sexually transmitted infection most often caused by Chlamydiae and Mycoplasmae. A few other organisms, as well as some nonsexual factors, also contribute to its etiology. NGU can result in considerable physical and psychological morbidity. In a few cases, it can lead to complications like reactive arthritis, and pelvic inflammatory disease, with their attendant morbidities. Correct diagnosis and treatment is therefore imperative in proper management of these cases. While earlier diagnostic support for these infections was limited and expensive, the advent of new methods like the nucleic acid amplification assays (NAA tests) has contributed significantly to better diagnosis. Treatment as per suggested guidelines and follow up of cases and contacts are all crucial in management. Counseling, including advice on behavior change, goes a long way in preventive strategies.
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Affiliation(s)
- Ibrahim Galadari
- Department of Dermatology, Faculty of Medicine, United Arab Emerites University, Dubai, United Arab Emerites.
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23
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Abstract
Defensins are endogenous, cysteine-rich antimicrobial peptides that contribute to host defence against bacterial, fungal and viral infections. There are three subfamilies of defensins in primates: alpha-defensins are most common in neutrophils and Paneth cells of the small intestine; beta-defensins protect the skin and the mucous membranes of the respiratory, genitourinary and gastrointestinal tracts; and theta-defensins, which are expressed only in Old World monkeys, lesser apes and orangutans, are lectins with broad-spectrum antiviral efficacy. Here, their discovery and recent advances in understanding their properties and functions are described.
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Affiliation(s)
- Robert I Lehrer
- Department of Medicine and Molecular Biology Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90095, USA.
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LEE JAYC, MULLER CHARLESH, ROTHMAN IVAN, AGNEW KATHYJ, ESCHENBACH DAVID, CIOL MARCIAA, TURNER JUDITHA, BERGER RICHARDE. Prostate Biopsy Culture Findings of Men With Chronic Pelvic Pain Syndrome do Not Differ From Those of Healthy Controls. J Urol 2003. [DOI: 10.1016/s0022-5347(05)63958-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- JAY C. LEE
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - CHARLES H. MULLER
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - IVAN ROTHMAN
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - KATHY J. AGNEW
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - DAVID ESCHENBACH
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - MARCIA A. CIOL
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - JUDITH A. TURNER
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - RICHARD E. BERGER
- From the Departments of Urology, Obstetrics and Gynecology, Rehabilitation Medicine, and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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25
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Abstract
Prostatitis is a common genitourinary disease in men. The National Institutes of Health has defined four types of prostatitis. The bacteriology of acute and chronic bacterial prostatitis is well understood. Causative organisms can be isolated by four-glass urine cultures. Chronic pelvic pain syndrome (CPPS; chronic abacterial prostatitis) is an enigma; whether there is a microbiologic cause for this condition is unknown. Researchers have postulated that CPPS may be an infectious disease of the prostate. This article reviews current literature regarding the microbiology of the prostate in CPPS.
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Affiliation(s)
- J C Lee
- Department of Urology, University of Washington, Box 356510, 1959 Pacific NE, Seattle, WA 98195, USA. jayclee @u.washington.edu
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26
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Abstract
The majority of cases of acute nongonococcal urethritis (NGU) are due to causes other than infection with Chlamydia trachomatis. Pathogens implicated as causes of nonchlamydial nongonococcal urethritis (NCNGU) include Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis, and primary infection with herpes simplex virus. In a majority of cases of acute NCNGU, no pathogen can be isolated. The etiology of chronic NCNGU is unknown.
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Affiliation(s)
- M A Schwartz
- Department of Medicine, University of Washington School of Medicine, Seattle, USA.
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27
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Schiefer HG. Microbiology of male urethroadnexitis: diagnostic procedures and criteria for aetiologic classification. Andrologia 1998; 30 Suppl 1:7-13. [PMID: 9629437 DOI: 10.1111/j.1439-0272.1998.tb02820.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Common pathogens and unconventional, fastidious bacteria, viruses, parasites, and fungi are causative agents in male urethroadnexitis. Uropathogens and sexually transmitted organisms must be considered. Diagnostic procedures and criteria for aetiologic classification in cases of balanitis, urethritis, prostatitis, epididymitis, and orchitis are described and evaluated.
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Affiliation(s)
- H G Schiefer
- Klinikum der Justus-Liebig-Universität, Giessen, Germany
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28
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Mazuecos J, Aznar J, Rodriguez-Pichardo A, Marmesat F, Borobio M, Perea E, Camacho F. Anaerobic bacteria in men with urethritis. J Eur Acad Dermatol Venereol 1998. [DOI: 10.1111/j.1468-3083.1998.tb00743.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Smith SM, Ogbara T, Eng RH. Involvement of Gardnerella vaginalis in urinary tract infections in men. J Clin Microbiol 1992; 30:1575-7. [PMID: 1624577 PMCID: PMC265332 DOI: 10.1128/jcm.30.6.1575-1577.1992] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Fifteen male patients from whose urine samples Gardnerella vaginalis was isolated (clinical incidence of 0.1%) were evaluated for clinical signs and symptoms of urinary tract infection and modality of acquisition of the organism. Ten of 15 (67%) patients were symptomatic or had signs of inflammation as manifested by an increased number of urinary neutrophils. One patient had two bouts of infection caused by this organism which required two courses of antibiotic therapy. Colonies of diphtheroidlike organisms found in urine cultures should not be ignored as insignificant but should be further investigated to determine whether G. vaginalis is present.
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Affiliation(s)
- S M Smith
- Microbiology Section, Department of Veterans Affairs Medical Center, East Orange, New Jersey 07018-1095
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31
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Kawamura N. [Sexually transmitted diseases]. Nihon Hinyokika Gakkai Zasshi 1991; 82:525-40. [PMID: 2051690 DOI: 10.5980/jpnjurol1989.82.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- N Kawamura
- Department of Urology, School of Medicine, Tokai University
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32
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Woolley PD. Recent advances in non-gonococcal urethritis: pathogenesis, investigation and treatment. Int J STD AIDS 1990; 1:157-60. [PMID: 2083289 DOI: 10.1177/095646249000100301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Woolley PD, Kinghorn GR, Talbot MD, Duerden BI. Microbiological flora in men with non-gonococcal urethritis with particular reference to anaerobic bacteria. Int J STD AIDS 1990; 1:122-5. [PMID: 2092786 DOI: 10.1177/095646249000100210] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In a microbiological study of the urethral flora in men with non-gonococcal urethritis (NGU), Chlamydia trachomatis (isolated from 30% of men) was the only organism isolated significantly more often from men with NGU than controls (P less than 0.01). Bacteroids species, especially of the melaninogenicus-oralis group, were the predominant anaerobic bacterial isolate from both men with NGU (isolated from 24%) and controls (isolated from 30%). There was no evidence that aerobic bacteria, anaerobic bacteria or herpes simplex virus made a significant contribution as primary pathogens in non-chlamydial NGU. Gram-positive cocci were the only anaerobic organism isolated more often from chlamydia-positive men (29%) than chlamydia-negative men (16%) with NGU (P less than 0.01). The significance of this remains unclear.
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Affiliation(s)
- P D Woolley
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
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34
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Woolley PD, Kinghorn GR, Talbot MD, Duerden BI. Efficacy of combined metronidazole and triple tetracycline therapy in the treatment of non-gonococcal urethritis. Int J STD AIDS 1990; 1:35-7. [PMID: 2099197 DOI: 10.1177/095646249000100109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In a double-blind placebo-controlled trial using triple tetracycline (Deteclo, Lederle) 300 mg twice daily for two weeks in conjunction with metronidazole (Flagyl, May & Baker) 400 mg or matching placebo twice daily for seven days, it was shown that the addition of anti-anaerobic therapy did not significantly affect the number of cases of persistent urethritis or the relapse of patients with non-gonococcal urethritis (NGU).
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Affiliation(s)
- P D Woolley
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
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35
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Schuster MW, Otth L, Gutiérrez MA, Tejero A, Moreno MI, Hering M. [Detection of Chlamydia trachomatis in urethral samples by direct immunofluorescence]. Rev Saude Publica 1989; 23:443-6. [PMID: 2701783 DOI: 10.1590/s0034-89101989000600001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The presence of Chlamydia trachomatis was studied by the direct immunofluorescence test, as also was that of Neisseria gonorrhoeae, Mycoplasma and Ureaplasma by the standard methods, in 82 patients with urethral discharge. Ch. trachomatis was found in 19.5% (16) of the cases and in 11 of them (68.8%) there was association with the other bacteria investigated. This eleven patients presented a scanty gelatinous discharge.
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36
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37
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Elsner P, Hartmann AA, Wecker I. Gardnerella vaginalis is associated with other sexually transmittable microorganisms in the male urethra. ZENTRALBLATT FUR BAKTERIOLOGIE, MIKROBIOLOGIE, UND HYGIENE. SERIES A, MEDICAL MICROBIOLOGY, INFECTIOUS DISEASES, VIROLOGY, PARASITOLOGY 1988; 269:56-63. [PMID: 3140532 DOI: 10.1016/s0176-6724(88)80084-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In a prospective study, urethral swabs were taken from 544 men presented to an STD clinic, 118 with and 426 without urethritis, and examined by microscope and/or culture for G. vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum, Mycoplasma hominis, Candida species and Trichomonas vaginalis. G. vaginalis was isolated from 4.2% of the males with urethritis and from 6.3% of those without urethritis. Using loglinear analysis, the following associations were significant (p less than 0.05): three-way: G. vaginalis, U. urealyticum, C. trachomatis; two-way: G. vaginalis, U. urealyticum and G. vaginalis, M. hominis and U. urealyticum, M. hominis. It is concluded that G. vaginalis is associated with genital mycoplasmas not only in the female, but also in the male urogenital tract.
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Affiliation(s)
- P Elsner
- Klinik und Poliklinik für Haut- und Geschlechtskrankheiten, Universität Würzburg
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38
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Casin I, Sanson-Le Pors MJ, Felten A, Perol Y. Biotypes, serotypes, and susceptibility to antibiotics of 60 Haemophilus influenzae strains from genitourinary tracts. Genitourin Med 1988; 64:185-8. [PMID: 2970427 PMCID: PMC1194197 DOI: 10.1136/sti.64.3.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Sixty strains of Haemophilus influenzae were isolated from the genitourinary tracts of adults: 19 from cervicovaginal secretions, one from a woman with bartholinitis, 37 from urethral exudates, and three from urine. Non-capsulated strains were recovered predominantly, and biotype III accounted for 28 isolates and biotype IV for 25. Many of the H influenzae strains were found to be resistant to one or more of the antibiotics commonly used against sexually transmitted diseases. Resistance to tetracycline was prevalent and was found in 17 of the strains. Ten strains were ampicillin resistant and beta lactamase producing. Kanamycin resistance was less common (two strains). Trospectomycin (U-63366), a new spectinomycin analogue, was eight to 16 times more active than spectinomycin. All the quinolones tested were very active against all strains and may provide an effective alternative for the treatment of resistant H influenzae in genitourinary infections.
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Affiliation(s)
- I Casin
- Service de Bactériologie-Virologie, Hôpital Saint-Louis, Paris, France
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39
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Caccamo F, Furneri PM, Di Marco R, Scimone MC, Rizza G. La Mezlocillina Nel Trattamento Delle Uretriti Non Gonococciche. Urologia 1987. [DOI: 10.1177/039156038705400407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | | | - G. Rizza
- Cattedra di Dermatologia Sperimentale
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40
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Lucas LM, Smith DL. Nongonococcal urethritis: diagnosis and management. J Gen Intern Med 1987; 2:199-203. [PMID: 3295152 DOI: 10.1007/bf02596152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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41
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Chambers CV, Shafer MA, Adger H, Ohm-Smith M, Millstein SG, Irwin CE, Schachter J, Sweet R. Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis. J Pediatr 1987; 110:314-21. [PMID: 3100755 DOI: 10.1016/s0022-3476(87)80180-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Urethral cultures were obtained from 90 adolescent youth, 16 of whom denied previous sexual activity. Among the sexually active boys was a group of 32 with clinically significant pyuria, consistent with the diagnosis of urethritis, on a first-part urinalysis (FPU) specimen. To relate differences in urethral microflora to sexual activity, 42 sexually active patients with a negative FPU were compared with the never sexually active group. The profile of anaerobic, but not aerobic, bacteria isolated from the urethra was related to the presence or absence of previous sexual activity. Mycoplasma species and Ureaplasma urealyticum were isolated from sexually active patients only, and may be markers of sexual activity in adolescent boys. Of the 32 patients with FPU evidence of urethritis, 22 (69%) had cultures positive for Chlamydia trachomatis, and an additional three (9%) had cultures positive for Neisseria gonorrhoeae. The findings in sexually active patients with a positive FPU were otherwise similar to those of sexually active patients without evidence of urethritis. C. trachomatis appears to be the most important agent of urethritis among adolescent boys with a positive FPU.
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42
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Abstract
The clinical course of a patient with vertebral osteomyelitis caused by Peptostreptococcus micros is described. The organism was isolated on two occasions from lumbar vertebral biopsies and was visualized in histologic sections of one of the biopsies. The patient had no apparent infections at other body sites. The infection was eradicated after 6 weeks of intravenous clindamycin therapy.
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43
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Rein MF. Clinical approach to urethritis, mucocutaneous lesions, and inguinal lymphadenopathy in homosexual men. Med Clin North Am 1986; 70:587-609. [PMID: 3754296 DOI: 10.1016/s0025-7125(16)30941-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The spectrum of sexually transmitted diseases observed among homosexual men is diverse, but in general includes the same infections observed among heterosexuals. A systematic approach to the diagnosis of these diseases, incorporating sexual history, predominant symptoms, findings from physical examination, and office laboratory evaluation will frequently yield a specific diagnosis. Prompt diagnosis and treatment of patients, and when appropriate, of contacts are of critical importance to the prevention of unnecessary morbidity and further transmission of disease.
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Hedelin H, Brorson JE, Grenabo L, Pettersson S. Ureaplasma urealyticum and upper urinary tract stones. ACTA ACUST UNITED AC 1985; 56:244-9. [PMID: 6544607 DOI: 10.1111/j.1464-410x.1984.tb05381.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The occurrence of bacteria and Ureaplasma urealyticum in the upper urinary tract was studied in 50 patients operated on for renal stones. Cultures were performed on voided urine, pelvic urine obtained during surgery and the stone. The chemical composition of the stones was analysed. Twenty-six stones were of metabolic origin and 24 infection-induced, i.e. composed of struvite and/or carbonate-apatite. Ureaplasma urealyticum was cultured from the upper urinary tract in 1 patient with metabolic stones, and in 7 with infection stones. In 4 of these 7 patients no other urease-producing micro-organism was detected, suggesting that Ureaplasma urealyticum may have been associated with stone formation in these patients.
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MESH Headings
- Abortion, Habitual/etiology
- Adult
- Animals
- Anti-Bacterial Agents/therapeutic use
- Clinical Trials as Topic
- Female
- Genital Diseases, Female/drug therapy
- Genital Diseases, Female/etiology
- Genital Diseases, Male/drug therapy
- Genital Diseases, Male/etiology
- Humans
- Infertility/drug therapy
- Infertility/etiology
- Infertility, Female/drug therapy
- Infertility, Female/etiology
- Infertility, Male/drug therapy
- Infertility, Male/etiology
- Male
- Mycoplasma/classification
- Mycoplasma/isolation & purification
- Mycoplasma Infections/drug therapy
- Mycoplasma Infections/microbiology
- Pregnancy
- Pregnancy Complications, Infectious
- Sperm Motility
- Spermatozoa/microbiology
- Ureaplasma/classification
- Ureaplasma/isolation & purification
- Urethra/microbiology
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48
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Abstract
The epidemiology, diagnostic criteria, and etiology of nonspecific urethritis in men are discussed. Microbiological examinations have indicated that in the vast majority of these patients Chlamydia trachomatis and Ureaplasma urealyticum are the main causes for the disease. Treatment of the disorder has centered on the use of tetracyclinelike drugs, and with proper treatment cure can be obtained in the majority of patients.
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49
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Azimi PH, Chase PA, Petru AM. Mycoplasmas: their role in pediatric disease. CURRENT PROBLEMS IN PEDIATRICS 1984; 14:1-46. [PMID: 6386349 DOI: 10.1016/0045-9380(84)90019-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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50
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Abstract
A microbiological examination has been carried out in 116 patients with unexplained infertility and with asymptomatic bacteriospermia. Organisms more frequently isolated were Staphylococcus epidermidis (81.9%), non hemolytic streptococci (23.3%), diphtheroids (25%) and alpha-hemolytic streptococci (18.1%). None of the 103 patients were positive for C. trachomatis. Mycoplasmas were isolated in 56 (48.3%) of the 116 examined samples, U. urealyticum was present in 49 (42.2%), M. hominis in 3 (2.6%) and both species in 4 (3.5%) samples of examined fluids. Forty-one of the 56 mycoplasmas-positive patients have been treated with doxycycline therapy. The treatment improved motility and caused decrease of coiled tails in 12 cases. Conception occurred in 5 (26.3%) of the 19 treated patients whose cultures were negative for mycoplasmas. These 5 pregnancies occurred in the patients that had high titers (greater than 10(5) c.c.u./ml) of ureaplasmas and in which the antibiotic therapy was successful. No pregnancy was seen in the other 22 patients where treatment failed to eradicate mycoplasmas.
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